Investigation or in vivo treatment device are known of the state of the art. Such devices take the form of a rigid tube of endoscope type or of a catheter constituted of a flexible tube which is inserted in the organism, especially by natural pathways or the vessels, and which allows to reach an organ or a specific tissue. These devices allow especially the elimination of blood clot or, when they are associated to optical fibres, the visualisation and the in vivo control of the state of a system, as the digestive tube, or of an organ, as the colon. The traumatism for the patient resulting from the use of such devices is then minimized but still stay to ameliorate. However, it is not always possible to carry out an analysis of the organs or the tissues in a patient with these devices. Such impossibility may result from the reduced accessibility of said tissue or organ compared to the blood circulation or the natural pathways, or from the difficulty to carry out a reliable diagnostic without having recourse to a fine study of the cells of said organ or tissue. In these cases, it is generally used in the state of the art and by now, the sampling of a fragment of said tissue or organ (biopsies) in order to ex vivo control the morphology of these tissues or organs, or more finely the one of their constitutive cells, especially by mean of fine needles (FNA or <<Fine Needle Aspiration>>: Engelstein et al., Br. J. Urol., 7: 210-213, 1994; Rodrigues et al., J. Am. Acad. Dermatol., 42: 735-740, 2000; Ariga et al., Am. J. Surg., 184: 410-413, 2002; Pérez-Guillermo et al., Diagn. Cytopathol., 32: 315-320, 2005; Fernandez-Esparrach et al., Arch. Bronconeomol., 43: 219-224, 2007). Moreover, it is also possible to analyse the expression status of a certain number of markers, the expression of which is correlated with a specific pathologic state (especially cancer, inflammation, infection, neurodegenerative disease or graft rejection).
However, these different methods, because of the sampling of a biopsy or of the aspiration of cells, involve a traumatism, sometimes important, to said tissue or organ and, consequently, to the patient. The organism of the latter may so be sorely afflicted because of haemorrhages or of the cicatrisation consecutively to the sampling, especially for certain organs (brain, pancreas, liver or lung).
It so exists still now a need for the identification of new investigation methodologies allowing to carry out a reliable and accurate diagnostic, especially compared to the expression of markers specifically associated to different pathologies such as cancer, inflammation, infection or neurodegenerative disease, while limiting the traumatisms inflicted to the patient.
The patent EP 1 358 481 describes an device of analysis or of in vivo treatment comprising (i) a micro-system of investigation of a substrate other than by analysis of a fluorescent signal, (ii) a flexible butt to an extremity of which is fixed said micro-system and the other extremity of which is intended to the control of said micro-system, (iii) a medical instrument having an internal opening in which said flexible butt may slide, (iv) a sliding system of protection of the micro-system that is removable on the level with the substrate, and (v) on the level of the said micro-system, a system of dilacerations of tissue or cell, eventually associated with one or several devices chosen among a device for monitoring by remote control by means of sensorial receptors (tactile, optical, physico-chemical or numerized informatic), for carrying out biopsies, for treatment, for local injection of biological or chemical products.
In order to allow the effraction of blood vessels and the dilacerations of tissues or cells, the micro-system is so associated with another more rigid system ensuring this function, preferably in distal position.
However, in the case of an in vivo investigation device, the investigation device is the more often directed to the target organ or tissue by using the endovascular or endocavitary pathway. The coupling of the micro-system with a dilaceration system then increases in a non-negligible manner the diameter at the extremity of the described device. The latter then reveal itself to be of a too complex use to be correctly directed to its target site without altering simultaneously the blood circulation pathways. Simultaneously, the coupling of multiple elements do harm to the general flexibility of the device, and so to its correct guidance, as to the obtention of the rigidity, necessary to allow the perforation of an organ or a tissue.